The VA’s Improved Transportation Service in 2015

va van

Many veterans who are currently eligible for VA health care benefits and have a VA authorized appointment are eligible for VTS. Every medical center has made up it’s own rules on who can get a ride on the shuttle. Some are  very restrictive.

Not everyone will be able to ride the bus.  The links below should take you to the VTS phone line in your location.

Scheduling a ride to the VA may get easier for vets living within 20-miles radius of a center in Minneapolis.   But this should help veterans who most need help with transportation and aren’t too far from a VHA.  It should help reduce appointment “no shows” once the word gets out. “No shows mean that a different vet had to wait longer for an appointment.  It will probably reduce the VA’s travel outlays once it gets going and pay for it’s self when word gets out.

To enhance the VHA system, the Central Business Office (CBO) is launching a new transportation program for immobilized and remote VA patients to enhance existing programs implemented by local VA Medical Centers (VAMCs).  Veterans Transportation Service (VTS) seeks to provide transportation services to include vehicle routing/scheduling software for VA Medical Facilities. The ride scheduling and routing systems will include GPS modules for VTS vehicles.

I organized a brown bag picnic by a lake for some of the oldies here on a A/C van just like this.  There was room for walkers and a scooter. It was fun for those who don’t drive to be picked up, dropped off, and then returned home after lunch and doing some walking.  It cost everyone $3.00 for a pleasant outing.

Posted in Guest authors, Medical News, VA Health Care, vA news | Tagged , , , , , , , , , , , , , , | Leave a comment

CAVC–CLARK V. SHINSEKI–YOUR MOMMA’S LYING

vetcourtappealspromoWhen you get to the CAVC, you at least get the Judge, or more appropriately, the judge’s little people, to thoroughly investigate a case; this in a far more balanced perspective than the slanted judicial Titanic deck of AOJ and BVA where they keep rearranging the deck furniture (the facts) to keep them dry.

Meet Mr. Edward Eugene Clark, a Veteran of the Cold War front in Germany. You can tell right off the bat that if Gene’s Grandma and Mom journeyed to Fort Jackson, South Carolina to see him after he got a heapin’ helpin’ of southern fried jetguns in 1972 that he probably was sick. Maybe not sick with a capital S  but enough to get momma on the warpath to Fort Jackson on a Greyhound with Grandma in tow for mutual comfort and support. I find women often travel in pairs when in distress. If you have two irate mommas coming after you as a medical professional, you better have majored in Public Speaking. We’re talking 1972. You can’t get a word in edgewise.

Gene Clark’s adventures in Indianaland

Six weeks after my son enlisted and was in boot camp, my mother and I visited him at [the] Fort Jackson[, South Carolina,] hospital, along with several dozen young men that seem to be affected by the same thing. We were never told what he had. Several weeks before his illness, when he was being inoculated for several things that are required by the [A]rmy[,] Gene described to me the condition of the pneumatic injection system used by the military. He described the condition of the apparatus[] as being covered with blood, skin, and pieces of flesh after dozens of soldiers had been inoculated ahead of him.  Clark v Shinseki (2011).

Sound familiar? Flu-like symptoms and prolonged fever? I’ve heard that so many times from a lot of you. Sounds a little like my jet gun indoctrination. I can’t say that I became ill though. I came down with it in full bloom along with Hep. B in 1971 -89 days after a minor encounter with an errant 7.62 rd.

downloadGene also had a claim in for his back that devolved into a nexus war. Let me show you how VA can build a medical record out of thin air. The blue below is VA examiner #1 who lays the groundwork for #2 (in red) who comes in behind a year or two later and pours concrete around #1’s “ruminations”. The Board then turns that into a rebuttal of the Presumption of Soundness(in purple) Note Examiner #1 uses terms like “If it was indeed a…” and “might be“, “I am unable to determine definitively“, etc. The Court has routinely labeled this as equivocal mumbo jumbo that leads to “probably not a good idea in my Courtroom.”  He admits he had a “back event” in the cervical area of the spine before service. He was declared sound for enlistment. He injured his back thrice in the service. That is all you need to know. He had no post-service injuries -just “surgical interventions” which do not constitute an injury. Well, unless you’re using a 26 year-old VA back surgeon named José with a MD from Guatemala Witch/Medical Doctor University. That’s why they wrote 38 USC §1151.

In the 2006 VA-ordered C&P, the examining physician (or ARNP, CNA, RN, LPN, bedpan changer) opined thusly:

In July 2006, Mr. Clark underwent a VA spine examination. The examiner stated that he reviewed Mr. Clark’s claims file. The examiner recorded (1) two pre-service back injuries; (2) three in-service injuries, two of which the examiner noted were not in Mr. Clark’s service medical records; and (3) three post-service “surgical interventions,” including spine injections.

After a physical examination, the examiner gave an impression of “[s]tatus post[- ]L5-S1 posterior lumbar interbody fusion” with “intermittent radiculopathic pain.”

‘To give an impression of’ translates into “Most doctors, but not all, might think it’s …” Radiculopathic pain is pain that shoots down out of your back/hips and into your leg. I have it from an unscheduled aircraft landing in what VA would probably call a sylvan (forested) setting..

In an addendum, after reviewing x-rays, the examiner opined: I think his back injury is related to [his] lumbar symptoms[,] so I do not think the cervical spine injury when [he] was 16 is related. However, I am unable to determine definitively if an injury to his lumbar spine in 1972 might be related to his current symptoms. I do not have x-rays to review; however, I think if it was indeed a mild lumbosacral strain that it is probably less likely than not that this injury is the cause of his current lumbar symptoms.

Sounds like someone who is conflicted until the thirty pieces of silver come out of the pouch. Okay, so far so good. You couldn’t convict OJ Simpson with that. Now we advance to Examiner #2 who will pick and choose select words, dodging the “might be related”s and the “do not think”s. Examiner #2 will create medical facts such as this brand new diagnosis:  ” if it was indeed a lumbosacral strain” metamorphoses into something entirely different below. Surgical interventions likewise loses it’s postcedent “interventions” and is abbreviated as “multiple back surgeries” now. Kind of reminds me of my fishing buddy Wade. Them fish got huge after a few years.

In October 2008, VA requested another spine examination, apparently under the mistaken belief that one had not yet been provided as directed by the Board’s June 2006 remand decision. [I’m so sure!] Later that month, a VA examiner reviewed Mr. Clark’s claims file and conducted an examination. The examiner noted two pre-service and three in-service back injuries, as well as three post-service surgical interventions. The examiner recorded Mr. Clark’s current complaints and symptoms and [T]he patient’s back condition is less likely than not related to his in[-]service lumbar strain. The patient is 53 years old. He has had multiple back surgeries. He had an injection beginning in 1983 and surgery in 1989 and 1995. These can certainly be from age[-]related changes or other just normal activities of life. Additionally, the cervical injury of 1971 from wrestling and the automobile accident [of] March 1972 with a diagnosis of lumbosacral strain, although he was asymptomatic on entrance exam[,] it is less likely not contributory to his current back condition.

Gene now carries a diagnosis of L5-S1 strain now instead of the more severe “injury” in Examiner #1’s C&P. Get used to this technique. In the process, they have just eviscerated his Presumption of Soundness in purple.  He also had numerous surgeries he’s plumb forgot. Now watch them do something similar to him on the Hepatitis C claim. Here’s Veterans Law Judge Vito A. Clementi’s version of how it went down:

Gene’s BVA decision.

 It is wholly unworthy of belief that medical services personnel of the U.S. military, in a peacetime environment and engaged in an activity directed towards ensuring the health of its members, would engage in such patently negligent performance of their duties so as to not ensure the hygiene of such [jetgun] immunizations.

As to [Mr. Clark’s] account of “stepping on needles” used by heroin addicts, it is also inherently incredible that [Mr. Clark], presumably knowing of his roommates’ predilections, would not have immediately reported to sick call instead of waiting over 20 years in this attempt to gain VA compensation. [His] allegations are contradicted by his [service medical records] which show that [he] never made a single complaint related to be stuck by an infected needle or scratched or bitten by other servicemen who were heroin addicts.Clark supra

Now let’s see what Judge Hagel’s minions had to say about that.

The Board essentially denied the existence of the second element–in-service incurrence– because it found that Mrs. Clark’s statement regarding Mr. Clark’s description of the circumstances of his inoculation was not credible. The Board did so because it simply could not fathom that the U.S. military would act in such a negligent manner. This conclusion is devoid of any actual analysis and is insufficient to support a finding of incredibility. See 38 U.S.C. § 7261(a)(4); Wood v. Derwinski, 1 Vet.App. 190, 193 (1991); Gilbert v. Derwinski, 1 Vet.App. 49, 52 (1990). At no time did the Board discuss military procedures for inoculating recruits during the period at issue, nor did the Board consider that such “negligence” is only negligent in hindsight: that is, what we today would consider a dangerous and unsafe practice as a result of the relatively recent understanding of blood borne diseases might have been standard practice at the time of Mr. Clark’s service. See VA Fast Letter 04-13 at 1 (June 29, 2004) (regarding the blood-borne nature of hepatitis C). Clark supra

The above in red is why I chose this decision. This will give you valuable ammo to cite when the next VLJ bozo comes out with a cogent “”That’s incredibabble” in your Hep C denial. See this as well:

The Board also found Mr. Clark incredible with respect to his statement regarding exposure to dirty needles used by heroin addicts and to being bitten and scratched by heroin addicts because of a lack of documentation in service medical records that he ever voiced his concerns about these events or sought treatment for bites or scratches. Although the Board characterized this as evidence weighing against Mr. Clark’s credibility and, ultimately, his claim, it is actually the absence of evidence, which is not the same as negative evidence. See Kahana v. Shinseki (2011) ; McLendon v. Nicholson (2006) Clark supra

Decisions like these are how we lose and think we never had a case. Words really do hurt. Everybody knows that-just like when Jesse blew off Nell and left her. You remember. He rode off on horseback into the “E” in The End in that car insurance commercial. What more proof do you need?

download (1)

Jesse?

Hang around me too long and you’ll need a shrink or a six pack of beer every hour. But that’s not the teaching moment. VA’s proclivity to cheat is.

Posted in BvA HCV decisions, CAvC HCV Ruling, HCV Health, HCV Risks (documented), Jetgun BvA Decisions, Jetgun Claims evidence, Nexus Information, VA Medical Mysteries Explained, Veterans Law | Tagged , , , , , , , , , , , , , , , , , , , | 3 Comments

VA training book, “How to Lie with Statistics,” outed

book

Screenshot from gov. hearing by C-Span

Did you happen to catch this story last (CNN video–6 minutes or AZTV) fall? The best-seller was studied at the VA until 8/14 when Sec. MacDonald pulled it from training programs. The book is not promoting lying per se but Huelskamp (Kansas), who sits on the Veterans Affairs Committee, doesn’t like it one little bit.  Rep. Huelskamp claims to know plenty about statistics from his Ph.D.. In any case,  who can resist a banned book!  (What, no protests from the American Library Association over this outrage?)

owl-ebook

“How to Lie With Statistics” $7.99 Kindle version “This book is a sort of primer in ways to use statistics to deceive…. The crooks already know these tricks; honest men must learn them in self-defense.” Grahic: openclipart.org

I’m joking about the ALA because I love librarians and their often unpopular stance on the freedom to read–everything.  But Rep. Huelskamp does make an important point about how data can be visually presented with graphics that give a wrong impression; he calls the VA out on one example. Actually, I want to read this book because the title is satire and with the catchy title, it’s sold a ton of copies.

I’m looking forward to reading Nate Silver’s book, The Signal and the Noise which is supposed to put statistics into contexts laypeople can relate to.  Amazon delivered it and it’s calling to me.  Although I got a decent grade in a required introductory statistics in college many moons ago, I struggled with the subject.  But given all the research I’ve been reading, I have to tackle this subject again so I can spot some statistical trends or lies.

 

Posted in Guest authors, Medical News, Nexus Information, Tips and Tricks, VA Health Care, VA Medical Mysteries Explained | Tagged , , , , , , , , , , , , , , , , , , | 4 Comments

Today’s trip to a non-VA ER

Walking the beagle led to a nasty fall on snowy concrete for my old Marine this afternoon. He entered the apartment (cussing at himself) with blood streaming out of his nose, cuts on his hand and a knee screaming “pain, pain!”  With a small hospital is less than two miles away, he insisted on driving himself. Two hours and several X-rays later, he arrived home with his red broken schnoz, bandages, and pain pills.

Nurse-Practise

I’m really glad he bought a Medicare Advantage Plan ($48.00 month w/o drug coverage), reasonable ER visit co-pay ($65.00), and 10% X-ray co-pay as a back-up.

I called the VHA hospital in Minneapolis and reported that he was in the ER.  The switchboard put me through to the VA ER.  A VA-ER staffer said to call back when he either is admitted or discharged.  So I did.  The ER staff pulled up his record, asked a few questions about the trauma, and that was that.  Said to send in the unpaid bills in case he’s eligible for any payments on them–and wished him well (typical of all the nice Minnesotans).  The VA staff was fast and efficient.

Will the VA pick up the costs his Medicare Advantage Plan will not since he didn’t call for non-VA ER care prior-authorization?  I cannot tell from this VA webpage (LINK) or Fact Sheet which problem he might fall under.

If someone has other insurance, including Medicare, they can refuse to be a payer. Will his Veteran’s Choice Card help?  Maybe because the VHA is not “feasibly available” to him (LINK):

A preapproval for treatment in the community is required for non-VA medical care – unless the medical event is an emergency. Emergency events may be reimbursed on behalf of the Veteran in certain cases. –

 

er va

CLICK IMAGE TO READ FACT SHEET

TRICKS & Traps Alert:: Under the “Mill Bill,” he has 90-days to get a claim in using form VA 10-583.  It’s a shorty.  Only one page to fill out and attach bills. Since insurance companies can take well over 90-days to pay, I think it’s prudent to send the form in next week without the bills, a copy of his coverage, and letter to say bills will be sent in as received.

So this is a real-time test of a real event and if the VA will help us with this emergency and after Congress has filled the coffers with funds for non-VA care. Our experience will be based on his individual circumstances versus rules we can all understand and rely on.  As they say on shopping forums, YMMV (Your Mileage May Vary).

Posted in Guest authors, Medical News, Medicare for VETS, VA Health Care, VA Medical Mysteries Explained | Tagged , , , , , , , , , , , , , , , , , , , , , | 2 Comments

BVA–THE SILVER QUEEN OF BALTIMORE

NodsterSurely over these last five years or so, you have heard me opine on members Leigh and Paul. They feel like family now to Cupcake and me. So it is with great pleasure that I finally induct them into the HCVets Winner’s circle. This has been a long, long battle and I feel it needs telling. 

Leigh served in the Navy during the period before latex gloves and sanitary precautions. She had a double whammy of jetguns and very invasive oral dental surgery in the 80s. She met the love of her life Paul, an ex Marine, as she was leaving the service and they have been together ever since. When she finally became ill, she and Paul started scouting for what could possibly have infected her. They filed for VA comp. and promptly got a vicious slap in the face.

VA stated that her pelvic inflammatory disease was an indicator of promiscuous behavior. The VA examiner further opined it was not incurred in service. Alternately, a small India ink tattoo applied when she was 12 with a sewing needle was undoubtedly the cause of the HCV. Basically it was anything but a jetgun or having molars excavated with a dentist’s jackhammer.

About that time they found me. We set out to build the perfect case. We had her John Hopkins liver transplant doctors write several nexus letters. Wait. I forgot to mention her liver crapped out in 2011. The Hep C promptly infected her new one. Imagine having to eat immune suppression drugs to keep her body from rejecting the new liverbox while it allowed the Hep to run rampant unchecked destroying it. It was a vicious circle.

The tale of woe began to go downhill when they tried to get their c-file to defend themselves and help win it. Baltimore’s RO ignored her repeatedly. After a year or two, I suggested a Writ. I finally suggested they go the attorney route because VA was laughing at her- not with her.   They armored up with none other than Keith Snyder, the mild-mannered Clark Kent type of guy who always gits ‘er done.  Sure enough, just like my writ for justice,  this produced quick results but they were still dogging her with an incomplete file. The story sped up when they filed for §20.900(c) to advance her on the docket.

Mr. Snyder did an admirable job as did Dr. Ben Cecil again. Armed with three good nexus letters, VA rightly caved in with their weak VA examiner nexus that wasn’t even plausible. I’ve held their hands in times of despair and setback. I’ve given them every piece of knowledge we have amassed over the last fifteen years of fighting these things. Rarely did three days go by without a pow wow. Last week the hard work culminated in Leigh’s win. I had far more confidence in this than they did. I told them and I’ll tell anyone that will listen. This is a recipe just like baking cookies. There are no shortcuts from the batter to the cooling rack. In Leigh’s case, the VA did a magnificent job of keepaway with her benefits for almost six years. Six long and painful years, I might add.

Leigh and Paul filed back in 2009 and got the first wave off in 2010. A DRO denial decision in January 2011 sent this to DC. Unfortunately, as most know, the VA seems to be using UPS Underground which digs a tunnel there. Then the c-file was unavailable. Baltimore’s RO was so booked out on backlog, they sent it to Providence Rhode Island for a DRo review and then to Detroit.  Go figure. Detroit was shipping their stuff to Fort Harrison by then. About the time she asked for a copy of her c-file, Detroit claims it sent it to Cheeseville. Everybody shrugged and acted like there were no flies on them. Fingers pointed everywhere but to Detroit.

Wounded Warrior Queen Leigh, son and Paul.

Wounded Warrior Queen Leigh, son and Paul.

Here’s the OGC’s Monday Morning Quarterback report. No EAJA for Keith either. After two years she got the files so what’s the beef? It’s not like they told her to get lost permanently. This jurisprudence casts a pall over Vet’s access to justice via qualified legal help. Why would an attorney even want to help a Vet like Leigh file a Writ if they can’t recoup the EAJA? It’s not like the Vet wins any money in a writ. In most cases, it’s a last ditch attempt to get what you need to prove your case.

Leigh’s Writ answer from VA.

Leigh’s Writ answer from Judge Davis

VA skated on this right up to Paul and Leigh’s ultimate win. They’ve been through a few boxes of kleenex and some long nights. I expect she’ll get a 100% P&T for the Hep alone. Being post-transplant, I can also see she’ll probably (or should) get SMC S for being substantially housebound. When you eat immune suppressors to prevent rejection of an organ, it leaves you open to every bug coming down the pike. Going out in public is taking a risk few would consider prudent.

We’ll naturally keep you posted as to the Big Brown Envelope from the Baltimore Prize Redemption Center. I think Paul and Leigh will be pleasantly surprised. You can’t get a transplant without losing one of your original 2,000 body parts. That’s pretty much 100% all by itself. Since they’ve waited for over six years for this, I think VA will want to be rid of them. Having Keith was their ace in the hole. Otherwise I could see VA stonewalling all the way to the court as they did me before granting.

Here’s the BBE from the BVA:

bva1bva 2bva 3bva 4bva 5bva 6

I call this a jetgun win. VA can say what they will, but our acting VLJ in tennis shoes has said it in no uncertain terms. Gene Groves filed a number of BVA decisions showing precedence and VA’s normal operating procedures to illustrate VA’s intransigence. We can certainly say this isn’t legal precedence but it clearly shows a unique style of argument to arrive at a win. That’s all that counts. It’s like Napalm or a Claymore. You simply have to get close.

As most know, Leigh and Paul own stock in Burpee’s seeds and have been drowning me in them. I just checked the freezer and I have about 40 quarts of Silver Queen left just in case they drop by for dinner. This is one of those wet eye posts for me. Leigh and Paul also were very generous for Butch Long’s false teeth funding drive. Rarely have I gone through this almost from start to finish with very many of you. Rob, Mark, Randy, Squidly, WGM- the list is growing ever longer than my memory. I can’t express the joy I feel when it happens. Sadly, for each of you we lead to a win, there are 30 who lose and never find this site.

Some say it’s futile to even try to conquer the behemoth VA. For them, I point to all the Leighs and Pauls that come back to share their wins with us. I leave you with this hope. I live by it,

644682_484919658207332_673615034_nIt made a difference for Leigh and Paul. I rest my case. I’d also like to personally thank God for allowing me to live long enough to get Leigh’s win for her.

Posted in BvA Decisions, BvA HCV decisions, HCV Health, HCV Risks (documented), Inspirational Veterans, Jetgun BvA Decisions, Medical News | Tagged , , , , , , , , , , , , , , , , , , , | 9 Comments

How HCV transmission could have been entirely prevented in medical interventions

downloadEven prior to the 1950’s, hepatitis transmissions were associated with diabetic treatments, transfusions, syringes, lancets, and the use of multi-dose vials. It’s taken decades for the CDC (and WHO) to get the message out but in the United States, the CDC’s One and Only One campaign is in full swing.  We owe it those who have died and will die from blood-borne pathogens from well-meaning invasive medical procedures, as simple as a diabetic pen, to get this information out.  

If you watch this training video or read the transcript designed for health care providers you will learn how this massive PAST harm was entirely preventable. 

CLICK ANY SLIDE IMAGE TO GO TO THE VIDEO ON YOUTUBE or view on the campaigns website here: (LINK)

hcv animation

Slide 12 Around 12 minutes into video. Animation!!! Image: CDC

We can see in the map below that bacterial injections are also a major concern but HCV seems to be the major focus of the presentation. The CDC does not include the Minot (ND) HCV outbreak among 51 patients and others where the cause is still being investigated. Nor does it include the CDC report on the jet injector transmission of HBV (MMWR June 13, 1986 / 35(23);373-6).

one and map slide three

 

prevention

“Wearing gloves and taking other infection control precautions aren’t just for your protection. The SIPC created this training to remind healthcare providers that the measures they take to protect themselves from bloodborne pathogens and other infection exposures, as required by the Occupational Safety and Health Administration (OSHA), also protect patients from healthcare associated infections. Injection safety and other basic infection prevention and control practices are central to patient and healthcare provider safety.” Image: CDC

Other highlights in the 20-minute training.  At about 5 minutes: Contaminated equipment info.  At about 6:13:  Viral hepatitis from unsafe injection practices.  At about 7:20 minutes: Drug diversion and HCV.  Exeter, NH case which we’ve covered on ASKNOD, is discussed.  At about 11 minutes, safer delivery designs are discussed;  about 12 minutes, blood back flow into multi-vials/ HCV contamination animation.  At conclusion, footnotes are given.

The training was published on YouTube in Dec. 2012 but has been viewed by under 9,000 people.

As mentioned, the use of multi-dose vials on jet injectors are not addressed but the concept is the same.  I predict that it will take private non-governmental funding to study the jet injectors which were in widespread use in the United States until our government withdrew their use after they recognized their threat to human health.

Posted in Guest authors, HCV Health, HCV Risks (documented), Medical News, Vietnam Disease Issues | Tagged , , , , , , , , , , , , , , , , , , , , , | 1 Comment

HCV & HIV news from the Conference on Retroviruses and Opportunistic Infections (CROI)

Seattle_spm

Seattle Photo credit: spm. Wikipedia Commons

Here’s a conference we can all get behind–the helpful presentation and sharing of information on HIV, HCV, and retroviruses.

From Seattle, Business Wire press release Gilead has announced that patients co-infected with HCV genotypes 1-4 and HIV can achieve a 96 Percent SVR12 Rate taking the “daily single tablet regimen Harvoni.®”  

The Foundation that sponsors the annual conference has provided open access slides and audio available to learn from (LINK).  Available workshop topics available now include:

Acute HCV: Is It Still Important to Diagnose and Treat?

HCV Genotype 3: Our Next Challenge

HCV Cirrhotics With Early Decompensation 

Ear_Headphones

Image: wikipedia Commons, PD.

To hear or see up-to-date information from the experts, just type in HCV in the search box and stream. Podcasts of talks are also available for downloads using Apple’s iTunes.  iTunes can be downloaded free to newer computers running Windows.  Apps can help move files to Android phones according to an article in Android Central here: (LINK) if you don’t own an iPhone.

For more information on Harvoni, please visit HCVETS here: (LINK).

Posted in Guest authors, HCV Health, HCV Risks (documented), Sofosbuvir | Tagged , , , , , , , , , , , , , , , , | Leave a comment

VAOIG–WE WERE UNABLE TO FIND ANY FINGERPRINTS ON THE FILES AT LITTLE ROCK

Capture oig

click me

As usual, six Four Deuce mortars signaled the arrival of the VA’s finest a month in advance of the pre-scheduled inspection. Nevertheless, Little Rock got their pee pee inextricably intertwined in the zipper. Before they could hire a Ryder RentaTruck to load up all the incriminating c-files with two year old suspense dates, the OIG surrounded the Puzzle Palace and blocked the exits.  

Some of you from San Smokeo seem to think the VA’s OIG fly in like the old-fashioned Air Force Operational Readiness Inspections Teams. The Commander of the Team grabs the commander of the Unit and holds him hostage while they observe how the Unit responds to various emergent situations. They were ugly and military folks treat them like the Police do Internal Affairs folks. Times have changed.

The VAOIG calls to make sure the RO’s Congressional Interests gal has made reservations at a good hotel and to get the weather report. Some even ask her to confirm their tee times. Hey. We’re all one big Happy VBA family, right? This is what the VA calls stakeholders. Everyone works together to make the wheels go round. There is no I in Team.

vaoigI find it depressing (once again on two fronts) to read this. Initially, it mimics what has been uncovered at numerous other ROs- the fudging of the dates on files under the aegis of a FAST Letter. The behaviour is a dead ringer for the VHA’s Phoenix Syndrome. Cook the books to feed the bonus machine.

I always like to turn it into a negative, as in photography, where white is black and vice versa. By viewing it in this context, you see the glaring obverse. Wouldn’t it be a scream if they showed up and everything was in order? The desks orderly with last week’s  new claims? The suggestion box bulging with new ideas? VBMS computer systems that actually worked in real time? Unicorns grazing on the front lawn?

talbot-photo

The OIG didn’t begin spilling the beans publicly until recently. The kicker before now was you had to ask for the report to find out because they didn’t publish the dirty laundry. Rending asunder centuries of splendid isolation is such a rude awakening.

______________________________________

Update:  Folks to thankheart-balloon

Little Rock VA Caught Defrauding 48 Veterans (LINK).”

  • The awesome RO VA employee who sent an anonymous tip to the OIG.
  • And to the OIG staff who wrote a short report after their timely surprise visit.

From the Executive Summary:

 On June 27, 2014, the Under Secretary for Benefits suspended use of Fast Letter 13-10 after the OIG determined staff were misapplying the guidance at another VARO. We had previously reported to the Under Secretary for Benefits that the guidance was used inappropriately to adjust dates of claims for unadjudicated claims discovered in the files. Changes to veterans’ claims were made to process old mail instead of unadjudicated claims information found in the files.

 

 

Posted in VA BACKLOG, vA news, VAOIG Watchdogs, VARO Misfeasance | Tagged , , , , , , , , , , , , , , , | Leave a comment

CAVC–DENNIS V. SHINSEKI–DENNIS THE MENACE GOES AWOL

vetcourtappealspromoHere’s one for the  HCV ammo pouch that Veterans would be wise to read. It certainly has other useful ramifications for a legal defense but the thrust is unique and needs to be iterated forcefully. Drug use is often used to tar and feather Hepatitis Vets. We know this and are constantly reminded we are second class citizens at VAMCs when we go in for treatment. The smirk I used to see cross my PCP’s countenance was all the reminder I needed that she didn’t believe for a moment that a Vietnam Veteran “caught” HCV from a GSW and subsequent transfusion. 

Willie C. Dennis gets the very same treatment from his providers and the VBA. They initially granted his claim for HCV based on good nexus letters from two private doctors without even making an effort to haul him in for their own C&P exam. Shortly thereafter, when Willie applied for an increase, they realized their mistake and set to work constructing an ironclad revision to strip him of the rating.

Willie Dennis’ immaculate redemption

There are no boundaries VA will not violate in pursuit of a lynching. Willie’s case was no different. He began his appeals to overturn this in 1997. He finally prevailed in 2011 when Sister Mary Schoelen of the Indiana Avenue Order of Holy Sanity  reversed the BVA and reinstated his grant.

It illustrates the enigma of CUE law quite well. VA always plays fast and loose with Clear and Unmistakable Error when they attack us. Mr. Dennis’ obverse of the coin is the bone of contention. Were you or I to come forward and insinuate CUE, we get short shrift and the usual Russell/ Caffrey/ Fugo litany of “a mere disagreement with the facts or the evidence can never rise to the level of CUE”. But should the shoe be on the other foot-VA’s in this case- the accepted practice devolves into a Presumption of Regularity that encompasses the idea VA has supernatural powers of extra sensory perception. They “know” when you are lying. They’ve got a wiretap on Santa’s phone. Their doctors can reach back into the past with alarming alacrity and somehow discern medical principles that would not be discovered for twenty years. One of my favorites is “The hepatitis Mr. Dennis suffered in 1972 is not at least as likely as not the Hepatitis C that he currently suffers.”

news_vetbeneJudge Schoelen didn’t need three wise men and a really bright star to ferret out the truth. VA was so clumsy their arrogance got the better of them. Their “There but for the grace of God go I the VLJ” is based on decades of flawed VA law. To compound that, they were trying to take Willie to the cleaners  in front of the wrong judge-one who could easily spot the error and was not afraid to call them on it.

Reversals are excellent test beds of jurisprudence to discern VA’s propensity to overreach. I’m not saying VLJ Singleton could have done a better (or worse) job of stringing up Mr. Dennis. They are all trapped in that mindset. Obviously he has a long litany of AWOls and Imperial entanglements that put him at risk for being a less than credible witness in his own defense. VA simply went overboard and too far afield when they tried to smear him. This always comes across as overkill to a knowledgeable Judge and prompts a more minute inspection to see what else is actually afoot.

Willie ain’t no saint but neither is he the pariah that VLJ Deborah Singleton tried to make him out to be. We all have our demons. Willie, it seems, has a few more than most but that does not condemn him or make him ineligible for VA compensation. VA’s “nonadversarial” slip was showing on this one.

The teaching moment is clear. You can have all manner of intransigence in your records but if the glove don’t fit, they can’t convict. Willie’s legitimate risks in service far outweighed his post service risks  of parenteral drug abuse. For VA to cast dem bones and say otherwise requires far more probative evidence- evidence they didn’t have and attempted to manufacture by innuendo. Sound familiar?

Posted in CAvC HCV Ruling, CAVC Knowledge, CUE | Tagged , , , , , , , , , , , , , , , , , | 4 Comments

How many of the 250,000 “other-than-honorable discharges” in the Vietnam-era were due to PTSD?

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173 Airborne Brigade in a firefight on Hill 823 during the Vietnam War. Photo: U. S. Army, Wikipedia Commons Date not given.

In an article (9/4/14) Washington Post reporter Dan Lamothe provides an   overview of Sec. Hagel’s medical guidance on PTSD and less than honorable discharges. He provides this background information:  “The lawsuit said 250,000 Vietnam-era veterans received other-than-honorable discharges, and that 80,000 of them could have post-traumatic stress.”  A VA Fact Sheet gives the number of veterans deployed to the Vietnam War (1964-1975) as 3,403,000; Battle Deaths: 47,434; Other Deaths (In Theater); 10,786 Other Deaths in Service (Non-Theater); 32,000.

Five veterans, Vietnam Veterans of America, Vietnam Veterans of America Connecticut State Council and the National Veterans Council for Legal Redress were represented by Yale Law School’s Veterans Legal Services Clinic.

Yale’s article and press release is here: (LINK) Yale has produced a great Fact Sheet (after Hagel’s (9/3/14) memo here:  (LINK)

VA  Pub. IB-10-488 (2/14) Other than Honorable Discharges and VA Health Care appears to be the most recent Fact Sheet.

A big “Thank You” to YLS and the Vietnam Veterans of America for being proactive for marginalized veterans who have been denied VA health care due to their bad discharges. Veterans in the 15 states where Medicaid has not been expanded, and the seven who are still “talking about it” they may be shut out of public/private health care–unless they can afford insurance coverage through their employer.  Any of these veterans infected with HCV will probably not get treatment and that’s wrong.  The orange states also have large general veteran populations and veteran sub-populations infected with HCV.

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Graphic from Kaiser Health Foundation. Click image to go to article.

The Vietnam Veterans of America is also taking on “Personality Disorder” dismissals, especially in the Coast Guard.  So again, Thank you. 

Posted in Guest authors, HCV Health, HCV Risks (documented), HOMELESS VETERANS, Medical News, Medicare for VETS, PTSD, VA Health Care, Vietnam Disease Issues, Vietnam War history | Tagged , , , , , , , , , , , , , , , , , , , , | Leave a comment